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Lithium And Stimulants


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#1 NOS

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Posted 10 December 2007 - 08:49 AM

Hi all! I'm giving consideration to adding a bit of lithium back to my cocktail (see below). I do know from my first trial with it, I might as well have not been taking any Adderall. I am aware that this is a known interaction, although I don't understand why it occurs. I'm curious, for others on lithium, are any of you on stimulants that work? Ritalin, etc? Or does lithium basically cancel out the effects of all stimulants? Thanks!
-Lauren
  • 0
Pertinent and probably some not so pertinent info:

DX: Not sure which of these are current or accurate anymore, but my money's on the last one to account for the symptoms...Generalized Anxiety Disorder, ADD, Depressive Disorder NOS, Bipolar Disorder NOS, Possible Fibromyalgia/Chronic Fatigue Syndrome (doc has suggested this, prescribed accordingly, but has yet to do any sort of evaluation to determine...I'm uninsured), PTSD

RX: Adderall 40 mg, Klonopin 2-4 mg, Trazodone 150-300 mg, Soma up to 3x daily as needed



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#2 Silver

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Posted 10 December 2007 - 09:22 AM

a couple of relevant questions before getting to the extremely interesting issue of lithium plus psychostimulants:

Why are you and your pdoc thinking about re-starting lithium?
What's the reason for the stimulant (fatigue, concentration, etc.)?
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#3 CER

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Posted 10 December 2007 - 10:32 AM

Hi all! I'm giving consideration to adding a bit of lithium back to my cocktail (see below). I do know from my first trial with it, I might as well have not been taking any Adderall. I am aware that this is a known interaction, although I don't understand why it occurs. I'm curious, for others on lithium, are any of you on stimulants that work? Ritalin, etc? Or does lithium basically cancel out the effects of all stimulants? Thanks!
-Lauren


Lauren,

From the Adderal Side Effects Page:

Adderall may not work at all when combined with lithium. So if lithium is the mood stabilizer that works for you, you're stuck with your ADD/ADHD symptoms if Strattera (atomoxetine) and/or Provigil (modafinil) didn't cut it for you.


From this I would gather that Strattera and/or Provigil are your best bets, and may be your only ones while on lithium.
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#4 NOS

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Posted 10 December 2007 - 01:24 PM

a couple of relevant questions before getting to the extremely interesting issue of lithium plus psychostimulants:

Why are you and your pdoc thinking about re-starting lithium?
What's the reason for the stimulant (fatigue, concentration, etc.)?


Lithium worked well for my mood, but I found the side effects intolerable at the "target dose." We're thinking that by adding a low dose of lithium to my Zyprexa that I'll get more symptom control than I am currently.

The reason fors the stimulant are fatigue, concentration, ADD-like symptoms. I was on Adderall for a while before ever starting any of the mood stabilizers.

I have tried Strattera, and it didn't go well. I haven't tried Provigil yet, but it is definitely out of my price range, and from what I understand, not as effective as Adderall. Although I guess once lithium is added to the mix, Adderall isn't all that effective.

-L
  • 0
Pertinent and probably some not so pertinent info:

DX: Not sure which of these are current or accurate anymore, but my money's on the last one to account for the symptoms...Generalized Anxiety Disorder, ADD, Depressive Disorder NOS, Bipolar Disorder NOS, Possible Fibromyalgia/Chronic Fatigue Syndrome (doc has suggested this, prescribed accordingly, but has yet to do any sort of evaluation to determine...I'm uninsured), PTSD

RX: Adderall 40 mg, Klonopin 2-4 mg, Trazodone 150-300 mg, Soma up to 3x daily as needed

#5 NOS

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Posted 10 December 2007 - 04:22 PM

Sounds like I shouldn't waste the money for the Provigil...that's not the first I've heard someone saying that. Hmmm...lethargy vs. potential stability...
-L
  • 0
Pertinent and probably some not so pertinent info:

DX: Not sure which of these are current or accurate anymore, but my money's on the last one to account for the symptoms...Generalized Anxiety Disorder, ADD, Depressive Disorder NOS, Bipolar Disorder NOS, Possible Fibromyalgia/Chronic Fatigue Syndrome (doc has suggested this, prescribed accordingly, but has yet to do any sort of evaluation to determine...I'm uninsured), PTSD

RX: Adderall 40 mg, Klonopin 2-4 mg, Trazodone 150-300 mg, Soma up to 3x daily as needed

#6 mj1127

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Posted 11 December 2007 - 12:09 PM

I'm taking Li and Vyvanse and it seems to work, but I didn't have a problem with Adderall and Li. I took 10mg of Adderall XR and am taking 30mg of Vyvanse. My pdoc is in love with the stuff and won't prescribe me Adderall anymore; I think it's ok, and it seems to last longer than Adderall, though I do think it makes me irritable sometimes. Either way, I'm stuck with it, and it's better than nothing.
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#7 NOS

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Posted 11 December 2007 - 06:49 PM

Clearly I'm not up to date, but what is Vynase? Is like Dexedrine XR?
  • 0
Pertinent and probably some not so pertinent info:

DX: Not sure which of these are current or accurate anymore, but my money's on the last one to account for the symptoms...Generalized Anxiety Disorder, ADD, Depressive Disorder NOS, Bipolar Disorder NOS, Possible Fibromyalgia/Chronic Fatigue Syndrome (doc has suggested this, prescribed accordingly, but has yet to do any sort of evaluation to determine...I'm uninsured), PTSD

RX: Adderall 40 mg, Klonopin 2-4 mg, Trazodone 150-300 mg, Soma up to 3x daily as needed

#8 CER

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Posted 11 December 2007 - 09:47 PM

Clearly I'm not up to date, but what is Vynase? Is like Dexedrine XR?


Some info for you here, here and here.

Of course there's always vyvanse.com if you want to get the real rosy picture. :mad:
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#9 NOS

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Posted 12 December 2007 - 09:41 AM

Ok, thanks!
-L
  • 0
Pertinent and probably some not so pertinent info:

DX: Not sure which of these are current or accurate anymore, but my money's on the last one to account for the symptoms...Generalized Anxiety Disorder, ADD, Depressive Disorder NOS, Bipolar Disorder NOS, Possible Fibromyalgia/Chronic Fatigue Syndrome (doc has suggested this, prescribed accordingly, but has yet to do any sort of evaluation to determine...I'm uninsured), PTSD

RX: Adderall 40 mg, Klonopin 2-4 mg, Trazodone 150-300 mg, Soma up to 3x daily as needed

#10 justmary

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Posted 12 December 2007 - 05:25 PM

Hi all! I'm giving consideration to adding a bit of lithium back to my cocktail (see below). I do know from my first trial with it, I might as well have not been taking any Adderall. I am aware that this is a known interaction, although I don't understand why it occurs. I'm curious, for others on lithium, are any of you on stimulants that work? Ritalin, etc? Or does lithium basically cancel out the effects of all stimulants? Thanks!
-Lauren


Um, no one told me that Adderall and Li don't play well together. I've been taking them together for about a year now. It has been working fine for me. I take 30mg of Adderall XR. Maybe it's some sort of combination of the numerous other meds I'm taking that makes it work for me.

JustMary
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#11 NOS

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Posted 13 December 2007 - 08:24 AM

Nobody told me either when I started on lithium, and when I asked my doc what was up, she suggested raising the dose, which didn't help. Apparently nobody told her either!
-L
  • 0
Pertinent and probably some not so pertinent info:

DX: Not sure which of these are current or accurate anymore, but my money's on the last one to account for the symptoms...Generalized Anxiety Disorder, ADD, Depressive Disorder NOS, Bipolar Disorder NOS, Possible Fibromyalgia/Chronic Fatigue Syndrome (doc has suggested this, prescribed accordingly, but has yet to do any sort of evaluation to determine...I'm uninsured), PTSD

RX: Adderall 40 mg, Klonopin 2-4 mg, Trazodone 150-300 mg, Soma up to 3x daily as needed

#12 justmary

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Posted 13 December 2007 - 03:38 PM

Nobody told me either when I started on lithium, and when I asked my doc what was up, she suggested raising the dose, which didn't help. Apparently nobody told her either!
-L


So am I just kidding myself that it's working? I know that when I tried Concerta/Ritalin/Ritalin LA I felt nothing. Focalin was a nightmare. Adderall really does seem to work. When I don't take it I can tell a big difference. Adderall is the main reason I remember to take my morning meds. If it wasn't in the mix I'd probably forget half the time.

Wonder if my pdoc knows about any of this. I'm going to have to ask. Anyone have a cite or two I can hand to him?

Mary
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#13 mj1127

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Posted 13 December 2007 - 07:26 PM

I don't have a problem with Adderall and Li, so I'm guessing it's not a problem everyone has. If it seems to be working for you, it probably is, and I wouldn't worry about it.
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#14 In_Remission_crazyRN

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Posted 14 December 2007 - 07:34 AM

I've been on Adderall 45mg and Lithium (various doses, currently 600mg) for the past four years without problems. Been having difficulty "tolerating" my workplace lately so my pdoc just switched me to Vyvanse which I started last night (working night shift). I've got to say I'm wiggin right now (9 hours later), not liking the side effects at all and NOT feeling focused. Anyone else have any experience with Vyvanse and lithium...some words of encouragement perhaps?? I'm not looking forward to another night of this...

#15 mj1127

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Posted 14 December 2007 - 02:30 PM

I've been on Adderall 45mg and Lithium (various doses, currently 600mg) for the past four years without problems. Been having difficulty "tolerating" my workplace lately so my pdoc just switched me to Vyvanse which I started last night (working night shift). I've got to say I'm wiggin right now (9 hours later), not liking the side effects at all and NOT feeling focused. Anyone else have any experience with Vyvanse and lithium...some words of encouragement perhaps?? I'm not looking forward to another night of this...


Well, it's better now than when I first started taking it. I have definitely noticed that how irritable it makes me is related to how stable - or rather how unstable I am. The better I'm feeling, the better it works. It also works better if I remember to eat, which didn't seem to be a factor with Adderall. What I have also noticed is that although the 30mg Vyvanse I'm taking now is supposed to be equivalent to the 10mg Adderall XR I was taking, it feels more like 15 or 20mg Adderall. I don't know what dose you're taking, but maybe less Vyvanse would be more for you. 30mg is the lowest, so unfortunately dumping out powder or getting used to it are my options, and I think I have gotten used to it.
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#16 In_Remission_crazyRN

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Posted 15 December 2007 - 07:48 AM

Thanks, tonight's MUCH better, but it's now nine hours after my dose (70mg!) and I'm getting headache again like last night. Also, when I got home from work last night after my ten hour shift, I ate nearly everything in my house...had the serious munchies (passed a KFC on my way home which unexpectedly spurred my appetite)...which is really odd (and an unexpected side effect) because I also had an upset stomach (a more expected side effect). It will be interesting to see what happens today when I get home...

#17 Jerod Poore

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Posted 15 December 2007 - 02:16 PM

Regarding lithium & Adderall:

The key word is may. As it is written in the PI sheet.

Lithium carbonate—The anorectic and stimulatory effects of amphetamines may be inhibited by lithium
carbonate.


This is all part of Shire's weasel wording of the entire PI sheet. They have every symptom of a manic reaction in the adverse reactions section, but nothing explicit that amphetamines can make someone manic as all get-out. This is based on studies done back in the 1970s on how lithium clobbered the effects of various amphetamines in about half the population of depressed patients, and using lithium as a potential treatment for amphetamine addiction.

There you go.

Dosages aren't available in the abstracts, and Adderall is different than the speed back then. At least some of the components are different. So mileage will certainly vary.
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#18 In_Remission_BpIsince1990

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Posted 06 June 2008 - 05:15 PM

Hi,

I'm almost at my "wits end" about this...I'm so frustrated...

I'm Bipolar I with rapid cycling and take Lithium 1650mg a day. Lithium is great for mood stabilization, and my doctor and I have (with much trial and error and pain) established that I can't go any lower on the Lithium dose.

But I have a lot of difficulty concentrating/focusing and getting my work done.

So, I've tried Adderall (20mg- up to 80mg/day) and Adderall XR... NO effect. Nothing. Nothing at all. : (

Now, I'm trying Ritalin. Today, I took a total of 60mg. No effect, except for a short, 30 minute period where I felt I was able to focus better. But it withered away quickly.

Is it really true that Lithium completely attenuates the effects of stimulants? Would you please share your stories with me? Because I'm so frustrated right now and am looking to confirm that my experience is not some "fluke" so that I can move on and try something else. I don't know what I would try next though...my doc doesn't seem to know either...

Thanks,
BpIsince1990

#19 In_Remission_fashionistalabella

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Posted 07 October 2008 - 05:41 AM

:mad:
Hi guys. I had asked this very question, somewhere else I think. Someone (jook) hey, thanks Jook...,was nice enough to lead me to this link. Anyway, this is my deal. Last yr. I was on Topomax, for my mood stabilizer and also Lamictal with Adderall. It blew my ADD out of the water. I was at my good weight, was able to go to college and make all A's and B's, no letharfy and eat healthy. I am 37-36 then, and I weighed 113 lbs-which is a good weight for me at 5'1. Okay, so back to why I asked a question here: I am now on a VERY low dose of Lithium 300-I started Adderall again (and by the way, I have gained 23-yes, 23 pounds in two and a half months with daily edema from starting Lithium) on Saturday. NOTHING!!!!!!! I might as well be throwing the Adderall down the toilet! So after 4 days of Nothing and still no focus, and my appetite being like a whale, I have decided to go off Lithium and back on Topomax. Also, I read in the AMA that it takes 48 hours ATLEAST-and up tp 5 days for Lithium to totally leave your system. I can not believe these Dr.'s don't tell us this and let us buy our ADD meds. Or scarier, do they not know? Okay, my rant is over. I hope this helps someone. And by the way, stopping Lithium is not a good option for everyone-just wanted to say that. Take care guys!

#20 Rayjean

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Posted 07 October 2008 - 01:30 PM

Perhaps if you are having daily edema & that much weight gain from Lithium, it would be worth having a good check of your kidney function to be on the safe side. Maybe you have already had the evaluated but, of course, one can have unknown kidney problems and then throw Lithium into the mix, and it gets noticeably worse. Just a thought. I think that is an awful lot of weight from edema and would wonder if there is not some other cause.
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#21 bunnyrabbit

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Posted 07 October 2008 - 04:13 PM

I take Provigil and Lithium and it works for me. I'm looks like I'm probably rare.
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Past meds: I've tried almost everything except MAOI's, half of the TCA's, Clozaril, Remeron and Serazone.

#22 mj1127

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Posted 11 October 2008 - 12:46 PM

I've had about 30lbs weight gain, much of it edema, with Lithium. My kidneys are fine as of my last blood work - it just works this way for some people. It is dose related, though, so the lower you can go, the less you are likely to have. At 300, though, it's unlikely you can go a whole lot lower.

Also to recap - I have taken both Adderall XR and Vyvanse with Li and had no interference.
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#23 In_Remission_SKITTLES

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Posted 11 November 2008 - 08:18 AM

Ive been on Li for 3 weeks and adderall 30 mgs. Never new about that side effect.

#24 bunnyrabbit

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Posted 22 November 2008 - 08:30 AM

I tried to go to a higher Lithium amount and it hit my thinking brain HARD! I took the prn Ritalin and it was like I never took it! [My prn Ritalin works fine with AP's and a lower lithium level].

My thought it maybe it's the lithium level and it's effect on stimulants. At a lower level, there is less of an effect. At a higher level, there is more of the dampening effect and stimulants seem to go nowhere. Just an idea and nothing I've read.
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Current Meds: Lithium Carbonate 900mg, Geodon 85-90mg, Artane 2.75mg, Klonopin 1-1.125mg, Adderral 20mg, Provigil 100mg, Prolixin .33mg.
Dosages are the daily total. Most meds are taken in smaller doses throughout the day.

Past meds: I've tried almost everything except MAOI's, half of the TCA's, Clozaril, Remeron and Serazone.

#25 starhawk1

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Posted 22 November 2008 - 08:45 AM

Provigil ! My Pdr will probably be switching me to Lithium and im takeing Adderal in my cocktail atm;

I hope I wont be Disappointed with the new cocktail....Provigil vs. Adderall xr ? Hmmmmmmmm Not so sure it can compare.
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#26 bunnyrabbit

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Posted 22 November 2008 - 12:22 PM

I think it'll depend on you as to which would work. I take Provigil daily and have Ritalin as a PRN for med induced stupidity. I didn't find the PRN Ritalin to help with higher doses of Lithium.

Since you are already taking Adderal, it would make since to continue that with the start of Lithium. Maybe it'll work, maybe you might need a dose increase, maybe you might need a different med. Everyone is different.
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Current Meds: Lithium Carbonate 900mg, Geodon 85-90mg, Artane 2.75mg, Klonopin 1-1.125mg, Adderral 20mg, Provigil 100mg, Prolixin .33mg.
Dosages are the daily total. Most meds are taken in smaller doses throughout the day.

Past meds: I've tried almost everything except MAOI's, half of the TCA's, Clozaril, Remeron and Serazone.


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